I have written several times about patient matching in the US, both in a blog entry and a published article. On December 11, 2017 the Office of the National Coordinator for Health Information Technology (ONC) sponsored a half-day “Interoperability in Action” webinar focused on Patient Matching Milestones at ONC (see agenda and slides). The webinar focused on four ONC projects from the past year. Here’s a quick run-down on what they covered.
On November 14-15, 2017, Mike Berry from HLN, with the Rhode Island Department of Health, attended the CDC Early Hearing Detection and Intervention (EHDI) Grantee Meeting in Atlanta. The meeting featured EHDI programs from
states and territories across the U.S., along with national experts in areas of hearing screening and diagnostic audiology as well as epidemiology, public health informatics, health outcomes and program evaluation.
Much of the meeting focused on the purpose and strategies of the current cooperative agreement between CDC and state EHDI programs. Similar to the Immunization Information System (IIS) Functional Standards in our IIS work, EHDI has its own set of EHDI Information System (EHDI-IS) Functional Standards; and the cooperative agreement is assisting grantees to meet those standards, as well as to evaluate their progress towards those and other program goals. There were also technical sessions on data linkage, tracking and surveillance; and group activities in which states shared their strategies on topics such as data exchange, stakeholder outreach, and program evaluation. Rhode Island is unique in that its EHDI-IS is part of KIDSNET, the state’s integrated child health information system; and at the meeting, we shared our recent experience deploying EHDI reports in KIDSNET to a wide variety of EHDI-related providers; as well as our current initiative to establish data exchange with audiologists’ Electronic Health Record Systems (EHR-S) for diagnostic audiology encounters.
On November 13, 2017 HLN held its first meeting of a newly-formed advisory board for its award-winning Open Source Immunization Calculation Engine (ICE) software. The ICE Review Board, as it will be known, is made up of a diverse set of public health, academic, and private-sector stakeholders. Its purpose is to provide feedback and recommendations for improving ICE and its related products. Working in conjunction with a Subject Matter Expert Workgroup, which is also convened by HLN and meets regularly to ensure that default ICE rules are being developed to adhere to Advisory Committee on Immunization Practices (ACIP) clinical guidelines, the Review Board will focus more on the overall direction and functionality of the clinical decision support products. This includes identifying enhancements or emerging needs of the clinical community for consideration. The Review Board is expected to meet quarterly.
ICE is a fully configurable vaccine forecasting/decision support web service tool which provides state-of-the-art clinical decision support for immunizations (CDSi). ICE can be used in Immunization Information Systems (IIS), Electronic Health Records (EHR), Health Information Exchanges (HIEs), and Personal Health Record (PHR) Systems. In June 2017, HLN was awarded the 2017 Upshot Award for Excellence in Vaccine Supply, Access, and Use by the U.S. Department of Health and Human Services National Vaccine Program Office (NVPO) for its work on ICE.
On November 8, 2017 Dr. Noam Arzt, President of HLN, participated in a panel discussion titled, “Advancing Electronic Case Reporting (eCR) to Enable Public Health Disease Control and Emergency Response: Getting Into the Technical Weeds.” Along with his colleagues from the University of Utah, the Association of Public Health Laboratories (APHL), and CGI Federal, this session discussed details of the current national implementation of electronic case reporting (eCR) including its sponsorship by the Digital Bridge project. Specifically, Dr. Arzt presented on various models of deployment for the clinical decision support (CDS) component of eCR, referred to as the Reportable Condition Knowledge Management System (RCKMS).
Dr. Arzt suggested in this talk that while there are strong reasons why a centralized decision support service is recommended at this time (and is in fact being deployed), other more decentralized CDS options are possible, including replication of the centrally-deployed software at a local site or incorporation of the national CDS rules themselves into a local CDS product (for instance, by using CQL). Given the diversity of systems in the US and the varying timetables for implementation, likely all these strategies will be enabled over time. The most important thing is for all these deployment strategies to rely on a single, consistent set of rules developed by public health and compliant with state and local jurisdiction law and policy.
Noam Arzt, president of HLN, has published a new article, “Why Cloud-Based Public Health Solutions are a Good Option for Clinical Decision Support” in OpenHealthNews. Cloud computing is one of the most powerful technology deployment strategies in use today. In this article Dr. Arzt examines some of the key reasons to host public health clinical decision support (CDS) solutions in the cloud. The article goes on to explain the difference between cloud computing and traditional computing. It then goes on to define Clinical Decision Support for Immunizations, or CDSi, and HLN’s Open Source Immunization Calculation Engine (ICE) and related tools and utilities. Finally, the article concludes with a discussion of how externally hosted services may provide some distinct advantages for organizations that deploy CDS tools such as these.